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CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2020; 41(01): 89-92
DOI: 10.4103/ijmpo.ijmpo_73_18
Practitioner Section

Multiple Small Bowel Perforations in a Patient of Chronic Myeloid Leukemia on Imatinib

Mahavir Virendra Kumar Tadaiya
Department of Surgical Oncology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat, India
,
Rajen A Tankshali
Department of Surgical Oncology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat, India
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Abstract

Chronic myeloid leukemia (CML) is a clonal hematopoietic disorder caused by an acquired genetic defect in a pluripotent stem cell. A series of discoveries led to the recognition that the BCR-ABL protein, which results from a reciprocal translocation involving chromosomes 9 and 22, has a central role in the pathogenesis of chronic myelogenous leukemia. The BCR-ABL protein functions as a constitutively activated tyrosine kinase (TK) and this knowledge led to the development of imatinib (STI-571), a drug that specifically inhibits the BCR-ABL TK. Common side effects of imatinib are low blood counts, nausea and vomiting, edema (swelling of the face, feet, and hands), muscle cramps and bone pain, diarrhea, hemorrhage, skin rash, and fever. Headache, fatigue, joint pain, indigestion, and abdominal pain are occasionally seen, and liver toxicity is a rare complication. We here report a case of multiple small bowel perforations in a patient of Ph+ve chronic myeloid leukemia-chronic phase on imatinib. Bowel perforation is a known complication for targeted therapy agents like bevacizumab, sunitinib, and sorafenib, which act on vascular endothelial growth factor receptor but imatinib having no anti VEGF receptor activity leading to such complication is a mystery. Physician treating their patient with imatinib should be aware of this complication and should act accordingly.

Keywords

Antivascular endothelial growth factor receptor - bowel perforation - chronic myeloid leukemia - imatinib - tyrosine-kinase inhibitor


Publication History

Received: 31 March 2018

Accepted: 18 October 2018

Article published online:
23 May 2021

© 2020. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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